Stream: implementers
Topic: Clinical Status of ICD-Z-Codes
Philipp Daumke (Oct 07 2019 at 13:30):
Hi all,
I have a maybe very specific question. As you're aware, ICD10CM contains a lot of Z-Codes dealing with "Personal history of ...", e.g. "Z85.6 Personal history of leukemia". My question: when representing this as a FHIR condition, what to set in the clinical status? Is it "resolved", as the patient doesn't have a leukemia any more, or is it "active" as the patient has an active condition of "Personal history of leukemia".
Any help or hint who could answer me that question, greatly appreciated.
All the best
Philipp
Lloyd McKenzie (Oct 07 2019 at 19:04):
@Michelle (Moseman) Miller
Michelle (Moseman) Miller (Oct 08 2019 at 15:59):
Note that Condition.clinicalStatus is optional (0..1). There is an invariant, con-3, that conditionally requires clinicalStatus (Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item), but it's only a guideline. The invariant explains why it is only a guideline:
This is (only) a best practice guideline because:
Most systems will expect a clinicalStatus to be valued for problem-list-items that are managed over time, but might not need a clinicalStatus for point in time encounter-diagnosis.
Generally speaking, in the US, problems are codified using SNOMED whereas diagnoses are codified using ICD-10. In short, if you don't have a clinicalStatus, then it isn't required.
Philipp Daumke (Oct 11 2019 at 15:03):
Hi Michelle,
thanks a lot for your information. I understand that clinicalStatus is not required. Nevertheless, can/should an ICD-Z-Code like "Z85.6 Personal history of leukemia" have a clinicalStatus "RESOLVED" or rather "ACTIVE"? I would argue for "ACTIVE" as I would say once you had a leukemia, you always have an ACTIVE state of "Personal history of leukemia", but I'm not sure whether my assumption is right?
Thanks a lot for your help.
Philipp
Last updated: Apr 12 2022 at 19:14 UTC
